Women have a lot on the line in the upcoming presidential election, particularly when it comes to their health. That’s because the two candidates, President Barack Obama and former Massachusetts Gov. Mitt Romney, have taken positions that could not be farther apart on a range of issues that directly affect women’s health and well being.

A signature reform of the Obama administration is the Affordable Care Act, more commonly known as Obamacare, which undertook a set of sweeping reforms designed to overhaul the private health insurance market as well as the Medicaid and Medicare programs. While Gov. Romney set in motion a similar reform in Massachusetts during his time as governor—a reform that in many ways served as a model for the Affordable Care Act—he has since shifted his perspective on health care policy and has vowed to repeal Obamacare “on day one” of his presidency.

Gov. Romney also endorses the budget proposed by House Budget Committee Chairman Paul Ryan (R-WI) and supported by the leadership of the House of Representatives—a budget that would not only dismantle the advancements made for women’s health through the Affordable Care Act but would lead to dramatic reductions in the services available to women through Medicaid and other key safety net women’s health programs.

Below is a detailed comparison of some of their positions related to women’s health.

Health insurance coverage

Medicaid

Medicaid is a joint federal-state health care program that provides health coverage to poor and low-income Americans as well as Americans with work-inhibiting disabilities.Because women are more likely than men to be poor, more women than men qualify for Medicaid. Women represent over half (59.2 percent) of Medicaid beneficiaries, more than 35 million women nationwide as of 2008 were beneficiaries, and Medicaid also provides 75 percent of public funding for family-planning services.

Through the Affordable Care Act the Obama administration dramatically expands coverage under Medicaid. If all the states agree to participate in the Medicaid expansion by 2014, 10.5 million currently uninsured women will qualify for Medicaid though a provision in Obamacare that expands eligibility to people with incomes below 138 percent of the federal poverty level, about $31,809 for a family of four in 2011. The provision loosens eligibility criteria by eliminating requirements that limit coverage to certain categories of people, such as pregnant women and parents, so women who are not pregnant or parenting will now receive coverage through Medicaid as long as they meet the income requirements.

Gov. Romney would repeal the entire Affordable Care Act, including the expansion of Medicaid, which would prevent 17 million people from gaining coverage over 10 years. He would also potentially roll Medicaid into a block-grant program, leading to cuts totaling $810 billion between 2013 and 2022.

Private insurance coverage for young adults

Women in their twenties have been among the least likely to have health insurance either because they are no longer in school; no longer eligible to stay on their parent’s insurance policy; working in part-time, temporary, or low-wage jobs that do not offer health benefits; or some combination of the above. Through the Affordable Care Act, President Obama allows women to stay on their parents’ health plans until the age of 26. More than 1 million young women have already benefited from this provision.

MittRomney has endorsed the Ryan budget, which would eliminate this coverage guarantee. The 1.1 million young women who have been able to stay on their parents’ plans would be at risk of losing their coverage under his plan.

Coverage for people with preexisting health conditions

Insurers routinely deny women coverage for gender-related “pre-existing conditions,” such as breast cancer, a Cesarean section, domestic violence, or sexual assault. Starting in 2014 that practice will be prohibited under Obamacare. In the meantime so-called Preexisting Condition Insurance Plans ensure that sick Americans who cannot get coverage in the current market will have access to affordable health insurance. More than 27,000 women with serious health conditions have already gained coverage under this provision and women comprise 53.7 percent of the enrollees in Preexisting Condition Insurance Plans.

Affordable health care

Maternity care coverage

While most women will need maternity care at some point in their lives, many women do not have adequate coverage for this vital service. Currently, 62 percent of individual health insurance market enrollees do not have maternity coverage.

Starting in 2014 Obamacare requires all health insurance plans to cover maternity care as an essential health benefit.But Gov. Romney would eliminate the requirement that insurance plans cover maternity care, through which 8.7 million women are set to gain such coverage.

Preventive health services

Obamacare also makes health care more affordable by guaranteeing no-cost coverage for a range of recommended preventive services such as mammograms, Pap smears, well-baby care, contraception, preconception and prenatal care in well-woman visits, gestational diabetes screening, lactation supports, and much more. In particular, contraceptive coverage will help reduce the unintended pregnancy rate for teens and adult women.

No-cost contraceptive coverage also will help women plan their pregnancies. This provision, combined with preconception and prenatal care, screening for gestational diabetes, and maternity care, will help improve pregnancy outcomes, including reducing the number of preterm births.

Gov. Romney would repeal the Affordable Care Act and take no-cost preventive care away from the 20.4 million nonelderly adult women who have already gained access to such care through the Affordable Care Act.

Family planning

Title X is our nation’s family-planning program. Title X clinics provided contraception to 4,683,290 women in 2008, which helped avert an estimated 973,000 unintended pregnancies. That same year there were 5,047,030 women under the age of 20 alone in need of contraceptive services and supplies. Every year Planned Parenthood provides contraception to 2.2 million patients. Contraception accounts for one-third of the services its health centers provide.

President Obama has increased access to family planning services through the Affordable Care Act’s Medicaid expansion, with a provision that makes it easier for states to cover contraception through Medicaid, and under the no-cost preventive services guarantee. He also stood up for Planned Parenthood when the leadership in the House of Representatives threatened to shut down the government unless he agreed to defund the organization.

Gov. Romneyhas said that he would eliminate Title X because it is not “essential” and because it benefits organizations such as Planned Parenthood, which provides abortion care with nonfederal funds. Moreover, when asked how he would cut the federal budget deficit, Gov. Romney’s response included that he would “get rid of” Planned Parenthood.

Interactive map

See the health needs of women in your state

Gov. Romney’s proposed health care policies would harm women swiftly and directly. Now that you know where President Obama and Gov. Romney stand on women’s health care, learn about the health needs of women in your state and see how their health will be affected by the election in November.

Click on the states to see how many women and girls are in need of health insurance, the percentage of women who today rely on a Pre-existing Condition Insurance Plan before Obamacare fully kicks in come 2014, the number of women in need of publicly funded contraception, the teen pregnancy rate, and the number preterm births that might be avoided with better access to preventive services and maternity care.

Jessica Arons is Director of the Women’s Health and Rights program at the Center for American Progress Action Fund. Lindsay Rosenthal is a Special Assistant with the program.The co-authors would like to thank Elizabeth Rich, a Women’s Health and Rights intern at the Center, for her research contributions to this interactive.